Contributors: López-Viñau,T; García-Martínez,L; Del Prado,JR Pharmacy Unit, Reina Sofia University Hospital, Cordoba, Spain. López-Viñau,T; Castón,JJ; Cano,Á; Recio,M; Pérez-Nadales,E; Torre-Cisneros,J Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides, Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba (UCO), Cordoba, Spain. Peñalva,G; Cisneros,JM Department of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, Virgen del Rocio University Hospital, Seville, Spain. Muñoz-Rosa,M; Martínez-Martínez,L; Gracia-Ahufinger,I Microbiology Unit, Reina Sofia University Hospital, IMIBIC, Department of Agricultural Chemistry, Edafology and Microbiology, University of Cordoba, Cordoba, Spain. Rumbao Aguirre,J; García-Martínez,E Hospital Management, Reina Sofia University Hospital, Cordoba, Spain. Salcedo,I Preventive Medicine Unit, Reina Sofia University Hospital, Cordoba, Spain. de la Fuente,C Intensive Care Unit, Reina Sofia University Hospital, Cordoba, Spain.; This research was funded by the Plan Nacional de I + D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0008; RD16/0016/0009) co-financed by European Development Regional Fund ‘A way to achieve Europe’ and Operative program intelligent Growth 2014–2020, which did not participate in the development of the program or the analysis of its results.
نبذة مختصرة : Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a critical public health threat, and carbapenem use contributes to their spread. Antimicrobial stewardship programs (ASPs) have proven successful in reducing antimicrobial use. However, evidence on the impact of carbapenem resistance remains unclear. We evaluated the impact of a multifaceted ASP on carbapenem use and incidence of CR-GNB in a high-endemic hospital. An interrupted time-series analysis was conducted one year before and two years after starting the ASP to assess carbapenem consumption, CR-GNB incidence, death rates of sentinel events, and other variables potentially related to CR-GNB incidence. An intense reduction in carbapenem consumption occurred after starting the intervention and was sustained two years later (relative effect -83.51%; 95% CI -87.23 to -79.79). The incidence density of CR-GNB decreased by -0.915 cases per 1000 occupied bed days (95% CI -1.743 to -0.087). This effect was especially marked in CR-Klebsiella pneumoniae and CR-Escherichia coli, reversing the pre-intervention upward trend and leading to a relative reduction of -91.15% (95% CI -105.53 to -76.76) and -89.93% (95% CI -107.03 to -72.83), respectively, two years after starting the program. Death rates did not change. This ASP contributed to decreasing CR-GNB incidence through a sustained reduction in antibiotic use without increasing mortality rates. ; Yes
Processing Request
No Comments.